Stereotactic Body Radiation Therapy Is Beneficial for a Subgroup of Patients with Urothelial Cancer and Solitary Metastatic Disease: A Single Institution Real-World Experience - Beyond the Abstract
Our most interesting finding was a subgroup of subjects (15%) that achieved long survival (range between 44 and 113 months at study cut-off). All these patients had a single metastatic lesion at the time of SBRT. The only death observed in this subgroup was not cancer-related (OS 94 months), whereas all other patients were still alive at the study cut-off date. Interestingly, one of these patients received SBRT sequentially several times due to the development of metachronous metastasis, including against a brain lesion.
SBRT was feasible with almost all patients receiving all planned radiotherapy doses, except for 1 subject who interrupted SBRT prematurely due to treatment-related pain. The local control rate was high with the vast majority of patients never developing disease recurrence in the irradiated lesion.
Our data indicates that SBRT in patients with only one metastatic lesion should be further studied and that systemic cancer therapy may eventually be postponed or even completely avoided in this patient population. This information is especially interesting in the current treatment scenario when intensive, toxic, and expensive therapeutic regimens are getting approved but data about when to pause or stop therapy is still not studied. Also, the optimal combination of SBRT with modern treatment regimens remains unexplored, as well as differences in systemic treatment outcome in patients with truly oligometastatic disease versus in those with more disseminated cancer."
Written by: Fernanda Costa Svedman, MD, PhD, Department of Oncology-Pathology and Department of Pelvic Cancer, Karolinska University Hospital, Stockholm, Sweden
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